Consumer Statement
In Accordance to Rule 15A NCAC 11, Section .1418(a)
DANGER – ULTRAVIOLET RADIATION
- Follow instructions.
- Avoid overexposure. As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions.
REPEATED EXPOSURE MAY CAUSE PREMATURE AGING OF THE SKIN AND SKIN CANCER.
FAILURE TO USE PROTECTIVE EYEWEAR MAY RESULT IN SEVERE BURNS OR LONG-TERM INJURY TO THE EYES.
- Medications or cosmetics may increase your sensitivity to the ultraviolet radiation. Consult a physician before using sunlamp or tanning equipment if you are using medications or have a history of skin problems or believe yourself to be especially sensitive to sunlight.
- If you do not tan in the sun, you are unlikely to tan from the use of this product.
- Consumers should report to the agency any injury for which medical attention was sought or obtained resulting from the use of registered tanning equipment. This report should be made within five working days after the occurrence.
Prior to my initial exposure, I was given the opportunity to read the warning above, it was provided to me by: Gina Newsome of Kool Rayz Tanning.
I believe to the best of my knowledge that the information contained is fully understood.
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Signature of Consumer Date:
For individuals UNDER the age of 18, parent or legal guardian must also sign consenting to the above warning and for use of tanning equipment.
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Consumer under the age of 18 Date Parent/Legal Guardian Date
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For illiterate or visually impaired person unable to sign their name.
I _________________________ of ______________________ have read the warning above to ______________________ in the presence of the witness _________________;
and to the best of my knowledge the consumer understands the risks associated with this warning.
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Operator Signature Date Witness Signature Date
RPS Consumer Statement
REV3-12/04